Comparison of Liver Biopsy with Hepascore in Patients with Hepatitis C-Genotype 1

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Fellow, Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Technical Manager, Laboratory, Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Specialist in Community Medicine, Statistics Consultant, Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Serum biomarkers can be used as alternative method for liver biopsy in order to assess the level of fibrosis in patients with chronic Hepatitis C. The determination of Hepascore is a non-invasive method to assess the level of fibrosis among patients. This study aims to compare the liver biopsy results with Hepascore among the Genotype 1 Hepatitis C patients in Isfahan.Methods: A sample of 39 patients with chronic Hepatitis C is selected through the simple non-random sampling method for a liver biopsy and Hepascore test. After biopsy, the patients are categorized based on the Metavir scoring system. The Hepascore algorithm is computed based on age, sex, total Billirubin, δ-glutamyl transferase, α2-Macroglobin, Hyaluronic acid. Using the Spearman and ROC test in SPSS15, collected data have been analyzed.Finding: The liver biopsy results showed 6 patients with F0, 12 patients with F1, 10 patients with F2, 3 patients with F3, and 8 patients with F4. The Hepascore value above 0.37 cut off point for detecting significant level of fibrosis has shown 67% sensitivity, 61% specificity, 67% positive predictive value, 61% negative predictive value. For a Hepascore value above 0.66, the results are: 82% sensitivity, 89% specificity, 75% positive predictive, 89% negative predictive value. For a Hepascore value higher than 0.84 for detecting cirrhosis, the results are: 100% sensitivity, 97% specificity, 89% positive predictive, and 100% negative predictive value.Conclusion: This study shows that the Hepascore method is accurate enough to measure the level of fibrosis, particularly cirrhosis. Therefore, it can use for screening of patients that need liver biopsy. 

Keywords

References

  1. Becker L, Salameh W, Sferruzza A, Zhang K, ng CR, Malik R, et al. Validation of hepascore, compared with simple indices of fibrosis, in patients with chronic hepatitis C virus infection in United States. Clin Gastroenterol Hepatol 2009; 7(6): 696-701.
  2. Strader DB, Wright T, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C. Hepatology 2004; 39(4): 1147-71.
  3. EASL International Consensus Conference on hepatitis C. Paris, 26-27 February 1999. Consensus statement. J Hepatol 1999; 31(Suppl 1): 3-8.
  4. Bedossa P, Dargere D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 2003; 38(6): 1449-57.
  5. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med 2001; 344(7): 495-500.
  6. Cadranel JF, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF). Hepatology 2000; 32(3): 477-81.
  7. Gilmore IT, Burroughs A, Murray-Lyon IM, Williams R, Jenkins D, Hopkins A. Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London. Gut 1995; 36(3): 437-41.
  8. Regev A, Berho M, Jeffers LJ, Milikowski C, Molina EG, Pyrsopoulos NT, et al. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 2002; 97(10): 2614-8.
  9. Rousselet MC, Michalak S, Dupre F, Croue A, Bedossa P, Saint-Andre JP, et al. Sources of variability in histological scoring of chronic viral hepatitis. Hepatology 2005; 41(2): 257-64.
  10. Lackner C, Struber G, Liegl B, Leibl S, Ofner P, Bankuti C, et al. Comparison and validation of simple noninvasive tests for prediction of fibrosis in chronic hepatitis C. Hepatology 2005; 41(6): 1376-82.
  11. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003; 38(2): 518-26.
  12. Adams LA, Bulsara M, Rossi E, DeBoer B, Speers D, George J, et al. Hepascore: an accurate validated predictor of liver fibrosis in chronic hepatitis C infection. Clin Chem 2005; 51(10): 1867-73.
  13. Parkes J, Guha IN, Roderick P, Rosenberg W. Performance of serum marker panels for liver fibrosis in chronic hepatitis C. J Hepatol 2006; 44(3): 462-74.
  14. Guechot J, Lasnier E, Sturm N, Paris A, Zarski JP. Automation of the Hepascore and validation as a biochemical index of liver fibrosis in patients with chronic hepatitis C from the ANRS HC EP 23 Fibrostar cohort. Clin Chim Acta 2010; 411(1-2): 86-91.
  15. Leroy V, Hilleret MN, Sturm N, Trocme C, Renversez JC, Faure P, et al. Prospective comparison of six non-invasive scores for the diagnosis of liver fibrosis in chronic hepatitis C. J Hepatol 2007; 46(5): 775-82.
  16. Halfon P, Bacq Y, De Muret A, Penaranda G, Bourliere M, Ouzan D, et al. Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C. J Hepatol 2007; 46(3): 395-402.
Journal of Isfahan Medical School
Volume 29, Issue 136 - Serial Number 136
March and April 2011
Pages 475-482

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History

  • Receive Date: 24 May 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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